Shoulder and Scapular Injuries and Special Test Flashcards
What are rotator cuff injuries?
SITS = supraspinatus, infraspinatus, teres minor, and subscapularis.
tendinopathies or tears = involvement in impingements
Ssx of Rotator Cuff Injuries
Pain
Limited ROM
Weakness of shoulder joint
Impingement
Assessments of Rotator Cuff Injuries
Can combine special test assessments with ROM and MMTs.
Empty can test
Drop arm test
Lift off test (gerberes test)
Bear hug test
Hornblower’s test
Infraspinatus test
Empty Can Test
Positive = inability to maintain arm position, pain
Indicates possible supraspinatus tendinopathy or tear
Drop Arm Test
Positive = inability to maintain arm position, pain.
Indicates possible supraspinatus tendinopathy or tear
Lift Off Test (Gerberes Test)
Positive = inability to move hand away from back, pain
Indicates possible subscapularis tendinopathy or tear.
Bear Hug Test
Positive = inability to maintain arm position against resistance.
Indicates possible subscapularis tendinopathy or tear.
Hornblower’s Test
Positive = pain or weakness
Indicates possible teres minor or infraspinatus tendiopathy or tear
Infraspinatus Test
Positive = inability to maintain arm position against resistance, pain
Indicates possible infraspinatus tendinopathy or tear, or subacromial impingement
What is shoulder impingement?
Impingement of either rotator cuff tendons or other soft tissues in subacromial space
Supraspinatus tendon, subacromial bursa, long-head bicep tendon
Ssx of Shoulder Impingement
Pain
Limited ROM especially overhead
Weakness of shoulder joint
Assessments of Shoulder Impingement
Check and work on posture.
Painful Arc Test
Hawkins-Kennedy Test
Painful Arc Test
Positive = pain between 60 and 120 degrees ROM in shoulder abduction.
Indicates possible shoulder impingement, but does not specify what structure (ie. supraspinatus, subacromial burse, and long-head biceps tendon).
Hawkins-Kennedy Test
Positive = increase pain
Indicates impingement of one or combination of structures (supraspinatus, subacromial burse, long-head biceps tendon).
What is glenohumeral instability?
Possible from dislocations, hypermobility, labral tears, capsular laxity.
Can be unstable in any direction.
-important to note which direction to identify involved structures.
Ssx of Glenohumeral Instability
Excessive movement of humeral head on glenoid fossa.
Decreased control of shoulder joint.
Limited or more ROM.
Repeated subluxation or dislocations.
Pain with movement,
Dead arm feeling (shoulder feeling like it wants to fall out of socket).
Weakness of shoulder stabilizers.
Assessments of Glenohumeral Instability
Sulcus sign (step deformity/indentation in joint)
Apprehension test
Sulcus Sign
Positive = increased inferior ROM, notched shoulder/step deformity.
Indicates inferior glenohumeral instability.
Apprehension Test
Positive = pain, guarding, or fear of movement.
Pain indicates possible impingement, guarding indicated glenohumeral instability.
What is a biceps tendon injury?
Tendinopathies or tears/ruptures.
Proximal or distal tendons (mostly long head bicep tendon).
-most likely proximal if ssx in shoulder
-distal associated with elbow
Often irritation in proximal bicipital groove
Ssx of Bicep Tendon Injury
Pain in shoulder or elbow flexion, limited ROM
What is a labrum tear or SLAP lesion?
Tears of labrum cartilage in glenohumeral joint.
Bankart tear = arterial labral tear.
SLAP = superior laberal tear from anterior to posterior of shoulder.
Ssx of Labrum Tears or SLAP Lesions
Deep ache pain.
Clicking/popping/catching
Shoulder instability.
Limited ROM.
Weakness
Assessments of Bicep Tendon Injuries or SLAP Lesions
Speeds Test
Bicep Load Test 1
Yergason’s Test
Speeds Test
Positive = increase in pain
Indicates possible bicipital groove tendinitis or SLAP lesion
Biceps Load Test 1
Positive = increased pain or ssx
Indicates possible SLAP lesion
Yergason’s Test
Positive = pain or instability.
Indicates possible instability or tendinitis of long-head biceps tendon
